1
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Hu M, Li W, Li P, Tan J, Wang Y. A case report of secondary B-cell acute lymphoblastic leukemia treated with a combination of FLT3 inhibitor and decitabine. Front Oncol 2024; 14:1329279. [PMID: 38737911 PMCID: PMC11082298 DOI: 10.3389/fonc.2024.1329279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 04/15/2024] [Indexed: 05/14/2024] Open
Abstract
Secondary acute lymphoblastic leukemia (s-ALL) refers to acute lymphoblastic leukemia that occurs after a previous malignant tumor, including therapy-related acute lymphoblastic leukemia (t-ALL) and prior malignant tumor acute lymphoblastic leukemia (pm-ALL). We report a case of a 51-year-old female patient who developed acute lymphoblastic leukemia 14 years after being diagnosed with diffuse large B-cell lymphoma (DLBCL). The patient was unresponsive to conventional chemotherapy for acute lymphoblastic leukemia (ALL) and achieved remission with a combination of sorafenib and decitabine based on the molecular biology characteristics of her B-ALL.
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Affiliation(s)
- Mengci Hu
- Department of Hematology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
| | - Wenzhe Li
- Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
| | - Pan Li
- Department of Hematology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
| | - Jie Tan
- Department of Hematology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
| | - Ya Wang
- Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
- Department of Hubei Provincial Clinical Research Center for Personalized Diagnosis and Treatment of Cancer, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
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2
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Riazat-Kesh YJRA, Mascarenhas J, Bar-Natan M. 'Secondary' acute lymphoblastic/lymphocytic leukemia - done playing second fiddle? Blood Rev 2023; 60:101070. [PMID: 36894417 DOI: 10.1016/j.blre.2023.101070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
Acute lymphoblastic/lymphocytic leukemia (ALL) occurring post-cancer diagnosis (secondary ALL - sALL) is increasingly recognized as a discrete entity, constituting up to as much as 5-10% of all new ALL diagnoses, and carrying its own biologic, prognostic and therapeutic significance. In this review, we will outline the history and current state of research into sALL. We will explore the evidence for differences underlining its existence as a distinct subgroup, as well as examining what might be driving such differences etiologically, including prior chemotherapy. We will examine these distinctions on population-, chromosomal-, and molecular-levels, and we will consider whether they translate to differences in clinical outcome, and whether they do - or should - warrant differences in treatment selection.
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Affiliation(s)
| | - John Mascarenhas
- Ruttenberg Treatment Center, Tisch Cancer Institute, 1470 Madison Avenue, 3rd Floor, New York, NY, 10029., United States of America.
| | - Michal Bar-Natan
- Ruttenberg Treatment Center, Tisch Cancer Institute, 1470 Madison Avenue, 3rd Floor, New York, NY, 10029., United States of America.
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3
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Dores GM, Linet MS, Curtis RE, Morton LM. Risks of therapy-related hematologic neoplasms beyond myelodysplastic syndromes and acute myeloid leukemia. Blood 2023; 141:951-955. [PMID: 36379026 PMCID: PMC10082352 DOI: 10.1182/blood.2022018051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/19/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Graça M. Dores
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Rochelle E. Curtis
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Lindsay M. Morton
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD
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4
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Murray NP, Orrego S, López MA, Munoz L, Minzer S. Common B-cell acute lymphoblastic leukaemia in a 70-year-old woman presenting 2 years after carboplatin-taxane radiotherapy for endometrial cancer. Ecancermedicalscience 2019; 13:972. [PMID: 31921343 PMCID: PMC6834386 DOI: 10.3332/ecancer.2019.972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Indexed: 11/16/2022] Open
Abstract
Therapy-related acute lymphoblastic leukaemia (t-ALL) is a poorly defined entity and is not featured in the World Health Organization classification as a distinct clinical entity from acute lymphoblastic leukaemia (ALL), thus differing from therapy-related acute myeloid leukaemia and myelodysplasia. We present a case of t-ALL occurring 18 months after treatment for metastatic endometrial cancer with a regimen of carboplatin, paclitaxel and radiotherapy. The patient presented with severe pancytopenia and diagnosed with common-B ALL, and the cytogenetic analysis showed a previously unreported deletion in chromosome 19 (q13.1) in 100% of the blast cells. The patient declined further therapy and died 1 month later. This rare but serious side effect of chemo-radiotherapy should be considered when deciding on treatment options for gynaecological cancers.
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Affiliation(s)
- Nigel P Murray
- Consultant Haematologist, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, Santiago, 7770199, Chile.,Professor Haematology, Faculty of Medicine, University Finis Terrae, Av Pedro de Valdivia 1509, Providencia, Santiago
| | - Shenda Orrego
- Physician General Medicine, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, Santiago, 7770199, Chile.,Tutor, Faculty of Medicine, University Mayor, Renato Sánchez 4369, Las Condes, Santiago, 27550224, Chile
| | - Marco Antonio López
- Physician General Medicine, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, Santiago, 7770199, Chile.,Tutor, Faculty of Medicine, University Mayor, Renato Sánchez 4369, Las Condes, Santiago, 27550224, Chile
| | - Lorena Munoz
- Tutor, Faculty of Medicine, University Mayor, Renato Sánchez 4369, Las Condes, Santiago, 27550224, Chile.,Consultant Internal Medicine, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, Santiago, 7770199, Chile
| | - Simona Minzer
- Physician General Medicine, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, Santiago, 7770199, Chile
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5
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Risk of Hematologic Malignant Neoplasms after Postoperative Treatment of Breast Cancer. Cancers (Basel) 2019; 11:cancers11101463. [PMID: 31569513 PMCID: PMC6827362 DOI: 10.3390/cancers11101463] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/17/2019] [Accepted: 09/25/2019] [Indexed: 12/31/2022] Open
Abstract
An indirect consequence of the improved long-term survival seen in patients with breast cancer (BC) is the increased risk of hematologic malignant neoplasms (HM). This study aimed to analyze the role of postoperative treatment for BC in the development of subsequent HM. Using the French National Health Data System, we examined the HM risks in patients diagnosed with an incident primary breast cancer between 2007 and 2015, who underwent surgery as first-line treatment for BC. Main outcomes were acute myeloid leukemia (AML), Myelodysplastic syndrome (MDS), myeloproliferative neoplasms (MPNs), multiple myeloma (MM), Hodgkin's lymphoma or non-Hodgkin's lymphoma (HL/NHL), and acute lymphoblastic leukemia or lymphocytic lymphoma (ALL/LL). Analyses were censored at HM occurrence, death, loss to follow up, or December 2017. The risk of each type of HM was compared according to the initial postoperative treatment of breast cancer. Of a total of 324,056 BC survivors, 15.5% underwent surgery only, 46.7% received radiotherapy after surgery, 4.3% received chemotherapy after surgery, and 33.5% received all three modalities. Overall, 2236 cases of hematologic malignancies occurred. Compared to the surgery alone group, AML was significantly increased after surgery plus radiation (aHR, 1.5; 95% CI, 1.0-2.1), surgery plus chemotherapy (aHR, 2.1; 95% CI, 1.2-3.6) and all modalities (aHR, 3.3; 95% CI, 2.3-4.7). MDS was significantly increased after surgery plus chemotherapy (aHR, 1.7; 95% CI, 1.1-2.5) or after all modalities (aHR, 1.4; 95% CI, 1.1-1.8). HL/NHL were significantly increased only in the radiotherapy and surgery group (aHR, 1.3; 95% CI, 1.0-1.6). A nonsignificant increase of ALL/LL (aHR, 1.8; 95% CI, 0.6-3.5) was noted after chemotherapy and with all three modalities (aHR, 1.4; 95% CI, 0.7-2.8). Our population based study revealed increased risks of various HM associated with postoperative BC treatment. The added benefit of chemotherapy and radiation therapy should take into consideration these long-term complications.
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6
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Therapy-related acute lymphoblastic leukemia: Where do we stand with regards to its definition and characterization? Blood Rev 2019; 37:100584. [DOI: 10.1016/j.blre.2019.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/21/2019] [Accepted: 06/17/2019] [Indexed: 11/23/2022]
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7
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Lee HY, Park CJ, Ahn A, Lee MY, Cho YU, Jang S, Seo EJ, Lee KH, Lee JH. Two Rare Cases of Therapy-Related Acute Lymphoblastic Leukemia in Patients With Plasma Cell Myeloma. Ann Lab Med 2019; 39:496-498. [PMID: 31037870 PMCID: PMC6502952 DOI: 10.3343/alm.2019.39.5.496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/07/2019] [Accepted: 03/29/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hye Young Lee
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Chan Jeoung Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
| | - Ari Ahn
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Min Yung Lee
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Young Uk Cho
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Seongsoo Jang
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Eul Ju Seo
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Kyoo Hyung Lee
- Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Je Hwan Lee
- Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
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8
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Ferraro F, Gao F, Stockerl-Goldstein K, Westervelt P, DiPersio JF, Ghobadi A. Secondary acute lymphoblastic leukemia, a retrospective analysis from Washington University and meta-analysis of published data. Leuk Res 2018; 72:86-91. [PMID: 30114560 DOI: 10.1016/j.leukres.2018.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 11/25/2022]
Abstract
Secondary acute lymphoblastic leukemia (s-ALL) is rare and poorly defined and data regarding outcomes post-transplant are lacking. Here, we report a detailed analysis of s-ALL at our Institution. Among 211 eligible patients with ALL from 2006 to 2017, 30 (14%) were defined as s-ALL and the remaining as primary ALL (p-ALL). s-ALL patients were older and had higher incidence of adverse risk factors. Overall response (OR) after induction was not different between s-ALL and p-ALL (79% versus 90% respectively, p = 0.106). S-ALL group had a higher risk of relapse (RFS) and death (RFS HR = 1.93, 95% CI 1.2-3.12, p = 0.007. OS HR: =1.95, 95% CI 1.18-3.23, p = 0.01). In multivariate analysis, the adverse effect of s-ALL on RFS and OS was no longer significant, however a pooled meta-analysis of our and published data indicated that s-ALL is an independent risk factor for lower OS (HR: 1.30, 95% CI: 1.11-1.52, p < 0.01). Myeloablative allogeneic transplantation in s-ALL was associated with lower rates of relapse and higher transplant related mortality without improvement in OS. These data indicate that s-ALL status should be considered for risk- stratification of newly diagnosed ALL. The optimal conditioning regimen for s-ALL patients undergoing allogeneic stem cell transplantation needs to be evaluated in a larger study.
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Affiliation(s)
- Francesca Ferraro
- Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Feng Gao
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Keith Stockerl-Goldstein
- Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Peter Westervelt
- Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - John F DiPersio
- Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Armin Ghobadi
- Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
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9
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Rosenberg AS, Brunson A, Paulus JK, Tuscano J, Wun T, Keegan THM, Jonas BA. Secondary acute lymphoblastic leukemia is a distinct clinical entity with prognostic significance. Blood Cancer J 2017; 7:e605. [PMID: 28885611 PMCID: PMC5709750 DOI: 10.1038/bcj.2017.81] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 07/20/2017] [Indexed: 01/21/2023] Open
Abstract
The effect of prior malignancy on the risk of developing, and prognosis of, acute lymphoblastic leukemia (ALL) is unknown. This observational study utilized the California Cancer Registry to estimate the risk of developing ALL after a prior malignancy using standardized incidence ratios (SIRs, 95% confidence intervals). ALL occurring after a malignancy with an SIR>1 (increased-risk (IR) malignancies) was considered secondary ALL (s-ALL). Adjusted hazard ratios (aHRs, 95% confidence intervals) compared the effect of s-ALL with de novo ALL on overall survival. A total of 14 481 patients with ALL were identified (1988–2012) and 382 (3%) had a known prior malignancy. Any prior malignancy predisposed patients to developing ALL: SIR 1.62 (1.45–1.79). Hematologic malignancies (SIR 5.57, 4.38–6.98) and IR-solid tumors (SIR 2.11, 1.73–2.54) increased the risk of developing ALL. s-ALL increased the risk of death compared with de novo ALL (aHR 1.38 (1.16–1.63)) and this effect was more pronounced among younger patients (age<40 years: aHR 4.80 (3.15–7.30); age⩾40 years: aHR 1.40 (1.16–1.69)) (interaction P<0.001). This population-based study demonstrates that s-ALL is a distinct entity that occurs after specific malignancies and carries a poor prognosis compared with de novo ALL, particularly among patients <40 years of age.
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Affiliation(s)
- A S Rosenberg
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology Oncology, University of California Davis School of Medicine, Sacramento, CA, USA.,University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | - A Brunson
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology Oncology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - J K Paulus
- Predictive Analytics and Comparative Effectiveness (PACE) Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - J Tuscano
- University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA.,VA Northern California Health Care System, Sacramento, CA, USA
| | - T Wun
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology Oncology, University of California Davis School of Medicine, Sacramento, CA, USA.,University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA.,VA Northern California Health Care System, Sacramento, CA, USA
| | - T H M Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology Oncology, University of California Davis School of Medicine, Sacramento, CA, USA.,University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | - B A Jonas
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology Oncology, University of California Davis School of Medicine, Sacramento, CA, USA.,University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA.,VA Northern California Health Care System, Sacramento, CA, USA
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10
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Allogeneic bone marrow transplantation for therapy-related acute lymphocytic leukemia after autologous hematopoietic stem cell transplantation for multiple myeloma. Ann Hematol 2016; 95:1739-40. [DOI: 10.1007/s00277-016-2762-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/20/2016] [Indexed: 10/21/2022]
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11
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Wu B, Ingersoll K, Rehder C, Sebastian S, Wang E. Sequential development of chronic myelogenous leukemia and primary myelofibrosis in a patient with history of large B-cell lymphoma treated with radiotherapy and chemotherapy: two myeloid neoplasms with distinct genotypic profiles suggestive of biclonality in a single individual. Ann Hematol 2016; 95:1383-6. [PMID: 27235173 DOI: 10.1007/s00277-016-2707-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 05/21/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Bin Wu
- Division of Hematology, Department of Medicine, Shengjing Hospital affiliated with China Medical University, Shenyang, People's Republic of China.,Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Kimberly Ingersoll
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Catherine Rehder
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Siby Sebastian
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA. .,Department of Pathology, DUMC Box 3712, M-345 Davison Bldg (Green Zone), Duke Hospital South, Durham, NC, 27710, USA.
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12
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Secondary acute lymphoblastic leukemia is an independent predictor of poor prognosis. Leuk Res 2015; 39:1342-6. [PMID: 26427729 DOI: 10.1016/j.leukres.2015.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/05/2015] [Accepted: 09/08/2015] [Indexed: 10/23/2022]
Abstract
Compared to secondary acute myeloid leukemia, secondary acute lymphoblastic leukemia (sALL) is poorly characterized. We utilized data from the Surveillance, Epidemiology, and End Results (SEER) 13 database to further elucidate patient characteristics and prognostic factors in sALL. Cases of adult de novo acute lymphoblastic leukemia (ALL) and sALL in patients with primary breast, rectum, cervix, or ovarian cancers or lymphoma with a latency period of at least 12 months were identified within the SEER 13 database. Survival in sALL and de novo ALL were compared after propensity matching based on age, gender, race, ALL subtype, and year of diagnosis. 4124 cases of de novo ALL and 79 cases of sALL were identified. sALL patients were older at diagnosis (median 62 years vs. 44 years; p<0.01). Overall survival (OS) in sALL was lower than de novo ALL (median 8 months vs. 11 months), 1 year OS: 35% vs. 47% (p=0.05), 2 year OS: 16% vs. 31% (p<0.01), and 5 year OS: 7% vs. 21% (p<0.01). Multivariate analysis revealed sALL as an independent predictor of worsened survival (adjusted HR 1.54; 95% CI 1.16-2.04, p<0.01) after propensity matching.
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13
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Loghavi S, Kutok JL, Jorgensen JL. B-acute lymphoblastic leukemia/lymphoblastic lymphoma. Am J Clin Pathol 2015; 144:393-410. [PMID: 26276770 DOI: 10.1309/ajcpan7bh5dnywzb] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This session of the 2013 Society of Hematopathology/European Association for Haematopathology Workshop was dedicated to B-acute lymphoblastic leukemia (B-ALL)/lymphoblastic lymphoma (LBL) with recurrent translocations and not otherwise specified. METHODS In this review, we summarize the cases discussed during the workshop, review the pertinent and most recent literature on the respective topics, and provide a few key points that may aid in the workup of patients with B-ALL/LBL. RESULTS Many of the submitted cases showed interesting diagnostic, immunophenotypic, or clinical aspects of B-ALL with BCR/ABL1, MLL-associated, and other recurrent chromosomal abnormalities. Several cases showed rare aberrancies such as coexistent IGH/BCL2 and MYC rearrangements and raised issues in classification. Other cases had unusual clinical presentations, including B-ALL with hypereosinophilia and therapy-related B-ALL. Several cases highlighted the role of flow cytometry immunophenotyping in distinguishing benign B-cell precursors from aberrant lymphoblasts, and other cases raised questions regarding the clinical importance of myeloperoxidase positivity in acute lymphoblastic leukemia. CONCLUSIONS The complexity and spectrum of cases presented in this review highlight the importance of clinicopathologic correlation and the value of ancillary studies in the classification and workup of patients with B-ALL/LBL.
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Affiliation(s)
- Sanam Loghavi
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston; and
| | | | - Jeffrey L. Jorgensen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston; and
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14
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Matnani R, Parekh V, Borate U, Brazelton J, Reddy V, Peker D. Therapy-related B-lymphoblastic leukemia associated with Philadelphia chromosome and MLL rearrangement: Single institution experience and the review of the literature. Pathol Int 2015; 65:536-40. [PMID: 26259760 DOI: 10.1111/pin.12337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 07/09/2015] [Indexed: 11/26/2022]
Abstract
Therapy related acute lymphoblastic leukemia (t-ALL) of B cell origin is rare and constitutes approximately 2% of all ALL. Previously compiled data on the complete cytogenetic analysis of 48 t-B-ALL cases suggested that MLL rearrangement at 11q23 gene locus is the most common abnormality. Philadelphia chromosome (Ph) and a normal karyotype were reported as the second and third most common karyotypes, respectively. We investigated cytogenetic karyotypes of six t-B-ALL cases with a pre-B cell immunophenotype. Ph + t-B-ALL was noted in four of six patients previously treated with radiation and/or chemotherapy. In addition, one case demonstrated MLL rearrangement at 11q23 locus while one case demonstrated normal cytogenetic karyotype. Five of the six t-B-ALL patients had persistent leukemia following initiation of chemotherapy for secondary leukemia with survival ranging from 10 to 21 months. To our knowledge, only fourteen patients with Ph + t-B-ALL have been described in the literature. In the current study, three of four cases with Ph + t-B-ALL were associated with treated breast carcinoma while one patient was treated for Hodgkin lymphoma. All four patients had undergone radiation therapy. The results may indicate a plausible association between Ph+t-B-ALL and prior radiation exposure.
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Affiliation(s)
- Rahul Matnani
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vishwas Parekh
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Uma Borate
- Department of Medicine, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jason Brazelton
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vishnu Reddy
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Deniz Peker
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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15
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Kelleher N, Gallardo D, González-Campos J, Hernández-Rivas JM, Montesinos P, Sarrá J, Gil C, Barba P, Guàrdia R, Brunet S, Bernal T, Martínez MP, Abella E, Bermúdez A, Sánchez-Delgado M, Antònia C, Gayoso J, Calbacho M, Ribera JM. Incidence, clinical and biological characteristics and outcome of secondary acute lymphoblastic leukemia after solid organ or hematologic malignancy. Leuk Lymphoma 2015; 57:86-91. [PMID: 25860236 DOI: 10.3109/10428194.2015.1040013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Acute lymphoblastic leukemia (ALL) following solid organ or hematologic malignancy (secondary ALL, s-ALL) is not well characterized. We analyzed the characteristics and outcome of patients with s-ALL and compared them with those of patients with de novo- ALL. Of 448 patients, 24 (5%) had previous neoplasia. Sixteen patients had received previous cytotoxic therapy (therapy-associated ALL, t-ALL), and eight had not (antecedent-malignancy ALL, am-ALL). Except for more advanced age in patients with s-ALL, no statistically significant differences were observed in WBC count, CNS involvement, immunophenotype or cytogenetics between the groups, nor in complete remission (t-ALL: 94%; am-ALL: 75%; de novo-ALL: 85%), 3-year remission duration (58%; 50%; 72%), overall survival (71%; 38%; 60%) or event-free survival (53%, 38%; 53%). Our study did not show poor clinical or cytogenetic features or inferior outcome in ALL patients with antecedent neoplastic disease, irrespective of the type of treatment received for the neoplasia.
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Affiliation(s)
- Nicholas Kelleher
- a Hematology Department of Institut Català d'Oncologia-Hospital Doctor Josep Trueta , Girona , Spain
| | - David Gallardo
- a Hematology Department of Institut Català d'Oncologia-Hospital Doctor Josep Trueta , Girona , Spain
| | - José González-Campos
- c Hematology Department of Hospital Universitario Virgen del Rocío , Sevilla , Spain
| | - Jesús M Hernández-Rivas
- d Hematology Department of Hospital Universitario de Salamanca & IBSAL , IBCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC Salamanca , Spain
| | - Pau Montesinos
- e Hematology Department of Hospital Universitario y Politécnico La Fe , Valencia , Spain
| | - Josep Sarrá
- f Hematology Department of Institut Català d'Oncologia-Hospital Duran i Reynals , L'Hospitalet de Llobregat , Spain
| | - Cristina Gil
- g Hematology Department of Hospital General Universitario de Alicante , Alicante , Spain
| | - Pere Barba
- h Hematology Department of Hospital Vall d'Hebron , Barcelona , Spain
| | - Ramon Guàrdia
- a Hematology Department of Institut Català d'Oncologia-Hospital Doctor Josep Trueta , Girona , Spain
| | - Salut Brunet
- i Hematology Department of Hospital de Sant Pau , Barcelona , Spain
| | - Teresa Bernal
- j Hematology Department of Hospital Central de Asturias , Oviedo , Spain
| | | | - Eugènia Abella
- l Hematology Department of Hospital del Mar , Barcelona , Spain
| | - Arantxa Bermúdez
- m Hematology Department of Hospital Marqués de Valdecilla , Santander , Spain
| | | | - Cladera Antònia
- o Hematology Department of Hospital Son Llàtzer , Palma de Mallorca , Spain
| | - Jorge Gayoso
- p Hematology Department of Hospital General Universitario Gregorio Marañón IiGSM , Madrid , Spain
| | - María Calbacho
- q Hematology Department of Hospital Ramón y Cajal , Madrid , Spain
| | - Josep-Maria Ribera
- b Hematology Department of Institut Català d'Oncologia-Hospital Germans Trias i Pujol . Jose Carreras Research Institute , Badalona , Universitat Autònoma de Barcelona, Spain
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16
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Ganzel C, Devlin S, Douer D, Rowe JM, Stein EM, Tallman MS. Secondary acute lymphoblastic leukaemia is constitutional and probably not related to prior therapy. Br J Haematol 2015; 170:50-5. [PMID: 25823602 DOI: 10.1111/bjh.13386] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/04/2015] [Indexed: 01/21/2023]
Abstract
Very little is known about secondary acute lymphoblastic leukaemia (s-ALL). This retrospective analysis studied a cohort of s-ALL patients treated at a single centre between 1994 and 2013, while comparing therapy-associated ALL (t-ALL) and antecedent malignancy ALL (am-ALL) patients. Thirty-two patients with s-ALL were identified. The overall incidence was 9.4% among ALL adults while T-cell s-ALL was rare (12% of s-ALLs). The median time interval between two malignant diagnoses was 5.3 years (range: 0.1-28). In contrast to previous reports, most of the s-ALLs were CD10 + and without KMT2A (MLL) abnormalities. The overall survival (OS) rates of the entire cohort at 12 and 24 months from ALL diagnosis was 49% and 25%, respectively. Most patients (n = 23, 72%) received prior chemo-/radio-therapy for their first malignancy (t-ALL) and only 9 (28%) did not (am-ALL). No significant difference was found in the incidence of B-/T- lineage ALL, extramedullary disease, blood count, and the rate of Philadelphia-positive ALL, nor in the rates of complete remission (P = 0.55) and OS (P = 0.97). This similarity, together with high incidence of family malignancy in both groups, raise the possibility that s-ALL patients may have an inherent predisposition to malignancies and a history of previous therapy may be of lesser importance in the pathogenesis of s-ALL.
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Affiliation(s)
- Chezi Ganzel
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Shaare Zedek Medical Centre, Jerusalem, Israel
| | - Sean Devlin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dan Douer
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Eytan M Stein
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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17
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Therapy-related ALL: cytogenetic features and hematopoietic cell transplantation outcome. Bone Marrow Transplant 2015; 50:746-8. [DOI: 10.1038/bmt.2015.8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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18
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Temozolomide-related acute lymphoblastic leukemia with translocation (4;11)(q21;q23) in a glioblastoma patient. J Clin Neurosci 2014; 21:701-4. [DOI: 10.1016/j.jocn.2013.07.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 07/06/2013] [Accepted: 07/12/2013] [Indexed: 12/26/2022]
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19
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Bonilla-Porras AR, Salazar-Ospina A, Jimenez-Del-Rio M, Pereañez-Jimenez A, Velez-Pardo C. Pro-apoptotic effect of Persea americana var. Hass (avocado) on Jurkat lymphoblastic leukemia cells. PHARMACEUTICAL BIOLOGY 2013; 52:458-465. [PMID: 24188375 DOI: 10.3109/13880209.2013.842599] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Abstract Context: Therapy for leukemia has a limited efficacy. There is a need to search for alternative anti-leukemia therapies. Persea americana Mill var. Hass (Lauraceae) is a tropical fruit (avocado) that might be used against cancer. Objective: To investigate whether P. americana induces death in Jurkat lymphoblastic leukemia cells. Materials and methods: Four ethanol extracts (0.1, 0.5, 1, 2 and 5 mg/mL) from avocado fruit (endocarp, whole seed, seed and leaves) were analyzed against Jurkat cells. Hydrogen peroxide generation by oxidation of 2',7'-dichlorodihydrofluorescein diacetate to the fluorescent compound 2',7'-dichlorfluorescein assay, acridine orange/ethidium bromide staining, flow cytometry analysis of annexin-V/7-amino-actinomycin, mitochondrial membrane potential and immunocytochemistry detection of transcription factor p53, caspase-3 and apoptosis-inducing factor (AIF) were evaluated. Results: Endocarp, seed, whole seed, and leaf (0.1 mg/mL) extracts induced significant apoptosis in Jurkat cells (p < 0.001) in an oxidative stress-dependent fashion via mitochondrial membrane depolarization (52-87%), activation of transcription factor p53 (6.3-25.4%), protease caspase-3 (8.3-20%) and predominance of AIF reactivity (20.6-36%) in all extracts. Similar results were obtained with 0.5 mg/mL extracts. However, extract ≥1 mg/mL concentration induced necrosis (100%). Conclusions: P. americana extracts function as a pro-apoptotic compound. Leukemic cells are eliminated through an oxidative stress mechanism. This study contributes to the understanding of the molecular mechanism of the avocado and its therapeutic action on leukemia.
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Affiliation(s)
- Angelica R Bonilla-Porras
- Neuroscience Research Group, Medical Research Institute, Faculty of Medicine, University of Antioquia , Medellín , Colombia
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20
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Mohamed EI, Mahmoud GN, El-Sharkawy RM, Moro AM, Abdel-Mageed SM, Kotb MA. Electronic nose for tracking different types of leukaemia: future prospects in diagnosis. Hematol Oncol 2013; 32:165-7. [PMID: 24030906 DOI: 10.1002/hon.2096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 07/26/2013] [Accepted: 08/15/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Ehab I Mohamed
- Departments of Medical Biophysics, Medical Research Institute, Alexandria University, Egypt
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21
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Mendivil-Perez M, Jimenez-Del-Rio M, Velez-Pardo C. Glucose Starvation Induces Apoptosis in a Model of Acute T Leukemia Dependent on Caspase-3 and Apoptosis-Inducing Factor: A Therapeutic Strategy. Nutr Cancer 2013; 65:99-109. [DOI: 10.1080/01635581.2013.741751] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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22
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TPEN induces apoptosis independently of zinc chelator activity in a model of acute lymphoblastic leukemia and ex vivo acute leukemia cells through oxidative stress and mitochondria caspase-3- and AIF-dependent pathways. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2012; 2012:313275. [PMID: 23320127 PMCID: PMC3540963 DOI: 10.1155/2012/313275] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 11/04/2012] [Indexed: 01/22/2023]
Abstract
Acute lymphoblastic leukemia is still an incurable disease with resistance to therapy developing in the majority of patients. We investigated the effect of TPEN, an intracellular zinc chelator, in Jurkat and in ex vivo acute lymphoblastic leukemia (ALL) cells resistant to chemotherapy. Changes of nuclei morphology, reactive oxygen species generation, presence of hypodiploid cells, phosphatidylserine translocation, mitochondrial membrane depolarization, immunohistochemical identification of cell death signalling molecules, and pharmacological inhibition were assayed to detect the apoptotic cell death pathways. We found that TPEN induces apoptosis in both types of cells by a molecular oxidative stress pathway involving O(2)(•-) > H(2)O(2) >> NF-κB (JNK/c-Jun) >p53> loss ΔΨ(m)> caspase-3, AIF > chromatin condensation/DNA fragmentation. Interestingly, TPEN induced apoptosis independently of glucose; leukemic cells are therefore devoid of survival capacity by metabolic resistance to treatment. Most importantly, TPEN cytotoxic effect can eventually be regulated by the antioxidant N-acetyl-cysteine and zinc ions. Our data suggest that TPEN can be used as a potential therapeutic prooxidant agent against refractory leukemia. These data contribute to understanding the importance of oxidative stress in the treatment of ALL.
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23
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Racke F, Cole C, Walker A, Jones J, Heerema NA. Therapy-related pro-B cell acute lymphoblastic leukemia: report of two patients with MLL amplification. Cancer Genet 2012; 205:653-6. [PMID: 23238285 DOI: 10.1016/j.cancergen.2012.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/29/2012] [Accepted: 11/03/2012] [Indexed: 11/30/2022]
Abstract
Improvements in chemotherapy and medical support of patients treated with chemotherapy and radiation have led to an ever-increasing number of cancer survivors. Unfortunately, a small fraction of these patients develop secondary hematologic malignancies as a consequence of their exposure to genotoxic anti-cancer regimens. Most of these are myeloid malignancies, therapy-related acute myeloid leukemia (t-AML) or myelodysplasia (t-MDS); however, a small but growing body of literature exists, which describes therapy-related acute lymphoblastic leukemias (t-ALL). Nearly all these cases are reportedly associated with translocations involving chromosome 11q23, the site of the MLL gene. We herein report two cases of ALL occurring after chemotherapy for other malignancies that showed complex karyotypic abnormalities and distinct MLL amplification by fluorescence in situ hybridization analysis. Immunophenotypic analysis showed that both cases expressed a pro-B cell (CD10-) phenotype with aberrant myeloid antigen expression. Although MLL amplification has been reported in therapy-related myeloid disease, to our knowledge this is the first report of MLL amplification occurring in therapy-related B cell ALL.
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Affiliation(s)
- Frederick Racke
- Comprehensive Cancer Center, Department of Pathology, Wexner Medical Center at The Ohio State University, Columbus, OH, USA
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24
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Tang G, Zuo Z, Thomas DA, Lin P, Liu D, Hu Y, Kantarjian HM, Bueso-Ramos C, Medeiros LJ, Wang SA. Precursor B-acute lymphoblastic leukemia occurring in patients with a history of prior malignancies: is it therapy-related? Haematologica 2011; 97:919-25. [PMID: 22207681 DOI: 10.3324/haematol.2011.057752] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Precursor B-acute lymphoblastic leukemia occurring in patients with a history of malignancies is uncommon, and this condition is not well understood. DESIGN AND METHODS A retrospective review of 457 adults with precursor B-acute lymphoblastic leukemia treated at our hospital identified 44 (9.6%) patients with prior malignancies. The clinical and genetic characteristics of this group of patients was compared with those of their counterparts with de novo disease and the relationship with prior chemoradiation therapy was assessed. RESULTS Thirty of 44(6.2%) patients received cytotoxic therapies, whereas 14 patients did not. The former group showed a significantly shorter interval from prior malignancy to onset of precursor B-acute lymphoblastic leukemia (36 versus 144 months; P = 0.002). Compared with 413 de novo cases, the frequencies of t(4;11)(q21;q23) (P<0.001) and hypodiploidy (P = 0.009) with loss of chromosome 5, 7 or 17 were significantly higher in patients who received topoisomerase II inhibitor and/or alkylating agents. By contrast, Philadelphia-positive and normal karyotype were more frequent in patients who either did not receive chemotherapy or received only local radiation or nucleoside analogs. Patients with precursor B-acute lymphoblastic leukemia following prior malignancies and chemoradiation were older, had a lower complete remission rate and showed an inferior survival in univariate, but not multivariate analysis. CONCLUSIONS The data support the interpretation that therapy-related precursor B-acute lymphoblastic leukemia does occur. In particular, cases associated with t(4;11)(q21;q23) or hypodiploidy with -5, -7, -17 are likely to be therapy-related and have a poor prognosis. The inferior outcome of these patients may be attributable to the high-risk cytogenetic abnormalities that are found in this group of patients.
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Affiliation(s)
- Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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25
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Abdulwahab A, Sykes J, Kamel-Reid S, Chang H, Brandwein JM. Therapy-related acute lymphoblastic leukemia is more frequent than previously recognized and has a poor prognosis. Cancer 2011; 118:3962-7. [PMID: 22180297 DOI: 10.1002/cncr.26735] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 09/07/2011] [Accepted: 09/08/2011] [Indexed: 01/02/2023]
Abstract
BACKGROUND Acute lymphoblastic leukemia (ALL) occurring in patients with a history of prior chemotherapy/radiotherapy exposure has been previously reported to be rare, accounting for <2.5% of ALL cases. METHODS All cases of adult ALL with a history of prior cytotoxic or radiation therapy at a leukemia referral center over a 13-year period were analyzed. RESULTS Twenty-three cases, representing 6.9% of all ALL cases, were identified. Of these, 17 (74%) had at least 1 high-risk feature; 8 (35%) had MLL rearrangements, and 4 were BCR-ABL(+) . MLL rearrangements were correlated with CD15 expression and absence of CD10, and also tended to have a shorter mean latency period and more prior topoisomerase II exposure. Twenty-one patients received induction therapy, and 18 (86%) achieved a complete response, 17 with 1 induction. Six patients have relapsed and died, and 4 others died of other complications, 2 of these postallogeneic stem cell transplantation. Median disease-free survival (DFS) and overall survival (OS) were 27 and 13.6 months, respectively, and 3-year DFS and OS were 37.1% and 37.6%, respectively. CONCLUSIONS The frequency of therapy-related ALL is higher than previously reported and has a poor prognosis, probably related to the high frequency of adverse risk features.
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Affiliation(s)
- Amal Abdulwahab
- Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Ontario, Canada
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26
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Motlló C, Manuel Sancho J, García O, Granada I, Millá F, Ribera JM. Leucemias agudas secundarias a tratamiento con quimioterapia y/o radioterapia: estudio de 23 pacientes. Med Clin (Barc) 2011; 137:449-52. [DOI: 10.1016/j.medcli.2010.09.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 09/10/2010] [Accepted: 09/14/2010] [Indexed: 10/18/2022]
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Bonilla-Porras AR, Jimenez-Del-Rio M, Velez-Pardo C. Vitamin K3 and vitamin C alone or in combination induced apoptosis in leukemia cells by a similar oxidative stress signalling mechanism. Cancer Cell Int 2011; 11:19. [PMID: 21663679 PMCID: PMC3127817 DOI: 10.1186/1475-2867-11-19] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 06/10/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Secondary therapy-related acute lymphoblastic leukemia might emerge following chemotherapy and/or radiotherapy for primary malignancies. Therefore, other alternatives should be pursued to treat leukemia. RESULTS It is shown that vitamin K3- or vitamin C- induced apoptosis in leukemia cells by oxidative stress mechanism involving superoxide anion radical and hydrogen peroxide generation, activation of NF-κB, p53, c-Jun, protease caspase-3 activation and mitochondria depolarization leading to nuclei fragmentation. Cell death was more prominent when Jurkat and K562 cells are exposed to VC and VK3 in a ratio 1000:1 (10 mM: 10 μM) or 100:1 (300 μM: 3 μM), respectively. CONCLUSION We provide for the first time in vitro evidence supporting a causative role for oxidative stress in VK3- and VC-induced apoptosis in Jurkat and K562 cells in a domino-like mechanism. Altogether these data suggest that VK3 and VC should be useful in the treatment of leukemia.
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Affiliation(s)
- Angelica R Bonilla-Porras
- School of Medicine, Medical Research Institute, University of Antioquia (UdeA), Calle 62 # 52-59, Building 1, Laboratory 411/412; SIU- Medellin, Colombia.
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28
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Yoo BJ, Nam MH, Sung HJ, Lim CS, Lee CK, Cho YJ, Lee KN, Yoon SY. A case of therapy-related acute lymphoblastic leukemia with t(11;19)(q23;p13.3) and MLL/MLLT1 gene rearrangement. Korean J Lab Med 2011; 31:13-7. [PMID: 21239865 PMCID: PMC3111038 DOI: 10.3343/kjlm.2011.31.1.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Therapy-related ALL (t-ALL) is a rare secondary leukemia that develops after chemotherapy and/or radiotherapy for primary malignancies. Chromosomal 11q23 abnormalities are the most common karyotypic alterations in t-ALL. The t(11;19)(q23;p13) aberration is extremely rare and has not been confirmed at the molecular genetic level. Here, we report a case of t-ALL with t(11;19)(q23;p13.3) and MLL-MLLT1 (alias ENL) gene rearrangement confirmed by cytogenetic analysis, multiplex reverse transcription-PCR (multiplex RT-PCR), and DNA sequencing in a patient who had undergone treatment for breast cancer. A 40-yr-old woman developed acute leukemia 15 months after undergoing 6 cycles of adjuvant chemotherapy (doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2), radiation therapy (dose, 5,900 cGy), and anticancer endocrine therapy with tamoxifen. The complete blood cell counts and bone marrow examination showed increased blasts and the blasts showed B lineage immunophenotype (positive for CD19, CD34, and cytoplasmic CD79a). Cytogenetic analysis revealed the karyotype 47,XX,+X,t(11;19)(q23;p13.3)[4]/46,XX[16]. FISH analyses, multiplex RT-PCR, and DNA sequencing confirmed the MLL-MLLT1 gene rearrangement. The patient underwent induction chemotherapy with fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper-CVAD) and achieved complete remission. Subsequently, she underwent consolidation chemotherapy, but died of brain ischemia in the pons and the region of the middle cerebral artery. To our knowledge, this is the first case report of t-ALL with t(11;19)(q23;p13.3) and the MLL-MLLT1 gene rearrangement.
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Affiliation(s)
- Byong-Joon Yoo
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
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29
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Shamsian BS, Gharib A, Rezaei N, Esfahani SA, Alavi S, Goudarzipour K, Arzanian MT. Development of secondary T-cell acute lymphoblastic leukemia in a child with hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 2010; 55:725-6. [PMID: 20589661 DOI: 10.1002/pbc.22578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a severe life-threatening disorder, characterized by hyperactivation of macrophages. A 12-year-old female was referred to our center; the diagnosis of HLH was made for the patient and immunosuppressive regimen was started. After a 2-year follow-up, the patient developed secondary T-cell acute lymphoblastic leukemia (T-ALL), confirmed by flow cytometric studies. Treatment was started based on T-ALL protocol, but the patient died because of relapse and sepsis. This case highlights the issue of secondary malignancy following HLH and demonstrates the need for continued follow-up in such patients.
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Affiliation(s)
- Bibi Shahin Shamsian
- Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shahid Beheshti Medical University, Tehran, Iran.
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Shim H, Chi HS, Jang S, Seo EJ, Park CJ, Lee JH, Lee JH, Lee KH. Therapy-related acute leukemia in breast cancer patients: twelve cases treated with a topoisomerase inhibitor. THE KOREAN JOURNAL OF HEMATOLOGY 2010; 45:177-82. [PMID: 21120206 PMCID: PMC2983048 DOI: 10.5045/kjh.2010.45.3.177] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 09/13/2010] [Accepted: 09/14/2010] [Indexed: 11/23/2022]
Abstract
Background Therapy-related myeloid neoplasm (t-MN) is a distinct class of acute myeloid leukemia (AML) in the World Health Organization (WHO) classification. Both AML and acute lymphoblastic leukemia (ALL) may develop after treatment for primary cancer. Topoisomerase inhibitors are commonly used to treat breast cancer patients and are well-known for their effect on leukemogenesis of therapy-related acute leukemias (t-AL). Methods We retrospectively evaluated bone marrow test results, chromosomal findings, and clinical characteristics of 12 patients who received topoisomerase inhibitors for breast cancer treatment and later developed acute leukemia. Results Fourteen patients (0.2%) developed t-AL after treatment for breast cancer. Topoisomerase inhibitors were administered to 12 patients. Among them, 9 patients (75%, 9/12) were diagnosed with therapy-related AML (t-AML) and 3 patients (25%, 3/12) with therapy-related ALL (t-ALL). Eight patients (67%, 8/12) showed translocation involving 11q23 and 3 different partner genes, 19p13.1 (37.5%, 3/8), 9p22 (37.5%, 3/8), and 4q21 (25%, 2/8). The median interval between completion of chemotherapy for breast cancer and occurrence of t-AL was 25 months. Patients with 11q23 translocation showed markedly poorer event-free survival than the group without involvement of 11q23. Conclusion The incidence rate of t-AL after treatment for breast cancer was 0.2% in a tertiary hospital in Korea. Translocation involving the MLL gene was frequently found in t-AL caused by a topoisomerase inhibitor and was related to poor prognosis.
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Affiliation(s)
- Hyoeun Shim
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
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31
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Montesinos P, González JD, González J, Rayón C, de Lisa E, Amigo ML, Ossenkoppele GJ, Peñarrubia MJ, Pérez-Encinas M, Bergua J, Debén G, Sayas MJ, de la Serna J, Ribera JM, Bueno J, Milone G, Rivas C, Brunet S, Löwenberg B, Sanz M. Therapy-Related Myeloid Neoplasms in Patients With Acute Promyelocytic Leukemia Treated With All-Trans-Retinoic Acid and Anthracycline-Based Chemotherapy. J Clin Oncol 2010; 28:3872-9. [DOI: 10.1200/jco.2010.29.2268] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose We analyzed the incidence, risk factors, and outcome of therapy-related myeloid neoplasms (t-MNs) in patients with acute promyelocytic leukemia (APL) in first complete remission (CR). Patients and Methods From 1996 to 2008, 1,025 patients with APL were enrolled onto three sequential trials (LPA96, LPA99, and LPA2005) of the Programa Español para el Tratamiento de Enfermedades Hematológicas and received induction and consolidation therapy with all-trans-retinoic acid (ATRA) and anthracycline-based chemotherapy. Results Seventeen of 918 patients who achieved CR developed t-MN (10 with < 20% and seven with ≥ 20% of bone marrow blasts) after a median of 43 months from CR. Partial and complete deletions of chromosomes 5 and 7 (nine patients) and 11q23 rearrangements (three patients) were the most common cytogenetic abnormalities. Overall, the 6-year cumulative incidence of t-MN was 2.2%, whereas in low-, intermediate-, and high-risk patients, the 6-year incidence was 5.2%, 2.1%, and 0%, respectively. Multivariate analysis identified age more than 35 years and lower relapse risk score as independent prognostic factors for t-MN. The median overall survival time after t-MN was 10 months. Conclusion t-MN is a relatively infrequent, long-term, and severe complication after first-line treatment for APL with ATRA and anthracycline-based regimens. Therapeutic strategies to reduce the incidence of t-MN are warranted.
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Affiliation(s)
- Pau Montesinos
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - José D. González
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - José González
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Chelo Rayón
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Elena de Lisa
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Maria L. Amigo
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Gert J. Ossenkoppele
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - María J. Peñarrubia
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Manuel Pérez-Encinas
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Juan Bergua
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Guillermo Debén
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - María J. Sayas
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Javier de la Serna
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Josep M. Ribera
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Javier Bueno
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Gustavo Milone
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Concha Rivas
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Salut Brunet
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Bob Löwenberg
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
| | - Miguel Sanz
- From the Hospital Universitario La Fe; Hospital Doctor Peset, Valencia; Hospital Insular, Las Palmas; Hospital Universitario Virgen del Rocío, Sevilla; Hospital Central de Asturias, Oviedo; Hospital General, Murcia; Hospital Río Hortega, Valladolid; Hospital Clínico Universitario, Santiago de Compostela; Hospital San Pedro de Alcántara, Cáceres; Hospital Juan Canalejo, A Coruña; Hospital 12 de Octubre, Madrid; Hospital Germans Tries i Pujol; Hospital Universitario Valle d′Hebron; Hospital Sant Pau,
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